title: Clinical, virological, and histologic evolution of hepatitis C virus infection in liver transplant recipients.
abstract: We designed a prospective study to assess the time course and evolution of hepatitis C virus (HCV) infection in 152 patients who underwent a liver transplantation (LT) in our institution. Forty-four recipients (29%) were infected by HCV after transplantation: 40 who developed recurrent infection after LT and four who acquired infection during or after LT. No differences were found in survival actuarial rates at 1, 2, and 4 years after transplantation for patients infected by HCV vs. noninfected ones. Graft hepatitis occurred in 66% of HCV-infected recipients: 18 developed chronic active hepatitis (10 of them with intense fibrosis) and 2 developed cirrhosis during the follow-up. Infection by the HCV-1b genotype was found in 79% of the infected recipients and in 100% of those in whom histologic evolution was worst. Fourteen grafts were lost in 44 HCV-infected recipients, in comparison with 12 in 108 HCV-negative patients (P = .007), mostly because of chronic rejection. HCV infection did not affect life expectancy in the midterm follow-up for LT patients. However, it was often associated with the occurrence of early and severe graft hepatitis and with a higher incidence of graft loss due to chronic rejection.
authors.affiliation: Infectious Diseases Unit, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Lumbreras
authors.forename: F
authors.initials: F
authors.lastname: Colina
authors.forename: C
authors.initials: C
authors.lastname: Loinaz
authors.forename: M J
authors.initials: MJ
authors.lastname: Domingo
authors.forename: A
authors.initials: A
authors.lastname: Fuertes
authors.forename: P
authors.initials: P
authors.lastname: Dominguez
authors.forename: R
authors.initials: R
authors.lastname: Gómez
authors.forename: J M
authors.initials: JM
authors.lastname: Aguado
authors.forename: M
authors.initials: M
authors.lastname: Lizasoain
authors.forename: I
authors.initials: I
authors.lastname: González-Pinto
authors.forename: I
authors.initials: I
authors.lastname: Garcia
authors.forename: E
authors.initials: E
authors.lastname: Moreno
authors.forename: A R
authors.initials: AR
authors.lastname: Noriega
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000401:mortality / Q000473:pathology* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence